Effective implementation of thromboprophylaxis strategies

doi:10.1136/bmj.39226.454236.3A

BMJ 2007;334:1128 (2 June), doi:10.1136/bmj.39226.454236.3A

Letters

Thromboprophylaxis for adults in hospital

Effective implementation of thromboprophylaxis strategies

The first 150 words of the full text of this article appear below.

We agree with Fitzmaurice and Murray that the risks to patientsof developing thromboembolism after surgery are well understoodby clinicians.¹ But the challenge of providing the recommended100% compliance of prophylactic measures is substantial andcan be met only by coordinated hospital wide strategies.

We recently completed an audit of thromboprophylaxis for surgicalpatients at a major oncological centre. Despite a high awarenessof the risks, over 50% of our patients were not receiving theirrisk appropriate prescriptions of low molecular weight heparin.Correct use of mechanical prophylaxis was achieved in over 80%of patients. The practice of thromboprophylaxis varied substantiallybetween different clinicians. Often no clearly designated doctor,surgeon, or anaesthetist was responsible in the team for implementingprophylaxis.

Patients should be classified into the risk categories suggestedby the National Institute for Health and Clinical Excellence(NICE) at the earliest opportunity, such as in pre-assessmentclinics, with . . . [Full text of this article]

Christian Schwiebert, specialist registrar anaesthesia, Imperial School, Royal Brompton Hospital, London SW3 6NP, Barry G Lambert, specialist registrar anaesthesia, Imperial School, Queen Charlotte's Hospital, London W12 0HS

Queen Charlotte's Hospital, London W12 0HS

eureka.chris@doctors.org.uk